Providing this information is VOLUNTARY and will be used for statistical purposes only. It will not be used by Springers Gymnastics or Gymnastics Saskatchewan for any other prohibited preference as per The Saskatchewan Human Rights Code.

Status/Treaty

Non-Status

Metis

Inuit

Mother / Guardian Name: *

Mother / Guardian Cell Phone: *

Father / Guardian Name: *

Father / Guardian Cell Phone: *

Emergency Contact Person (other than mother/father): *

Emergency Contact Phone Number: *

Emergency Contact Relation to Gymnast: *

Name to be used on Income Tax Receipts: *

We will be applying to KidSport(TM): *

No

Yes

Program Fee: *

$250.00

Discounts:

I understand that there are two mandatory fundraisers for all recreational members in the fall (chocolates and raffle). I also understand that I may choose to "buy-out" my chocolate fundraiser, but I must sell my raffle tickets. Initials: *

Chocolate Fundraiser: *

I understand that I am obligated to sell my raffle tickets ($50 booklet). I will provide Spingers Gymnastics with a cheque for $50, post-dated to October 1, on the first day of class or at time of payment. Initials: *

Gym Sask / Gym Canada Fee (ALL ATHLETES) *

This annual $31 Gymnastics Saskatchewan / Gym Canada Fee (insurance) must be paid by all athletes. The Gym Sask and Gym Canada Fee is non-refundable. I have initialed that I have read and understand this. Initials: *

A $25 charge on all NSF cheques will be issued by Springers Gymnastics. I have initialed that I have read and understand this. Initials: *

Refunds will be pro-rated to the week of withdrawal. No refunds will be issued after three classes. I have initialed that I have read and understand this. Initials: *

Payment or Payment Plan is due no later than the first day of class by cheque, cash, or e-transfer (mail@yorktonspringers.com). Should this not occur, your child will not be allowed on the gym floor. A minimum of 6 gymnasts is required for a class to run. I have initialed that I have read and understand this. Initials: *

A NON-REFUNDABLE deposit of $50 is required to hold a spot for my child in this class. Payment can be made by e-transfer (mail@yorktonspringers.com) or by mailing a cheque (P.O. Box 2027 Yorkton, SK, Canada S3N 3X3). I have initialed that I have read and understand this. Initials: *

“I”, the undersigned participant or guardian of participant listed above, do hereby acknowledge that I am aware of all activities normally required in and associated with participation in the Springers Gymnastics Club. I do hereby consent to the participant fully participating and know of no condition, which may affect the ability of the participant from safely participating. I waive and release all rights and claims for damage, which I may hereafter accrue to me against the Springers Gymnastics Club, their organizer, or their respective officers, agents and representatives. I acknowledge that Springers Gymnastics Club reserves the right to require a medical certificate from any participant. Photos and/or names of participants doing gymnastics activities may be published on bulletin boards, in newsletters, media such as the newspaper, promotional material, and social media. Signature of Parent/Guardian: *